One trend in medical education is to force students into a learning style called problem-based learning. You and your team are given a fictitious patient with a variety of symptoms and laboratory values with the goal of figuring out what’s going on. You’re never given the answers outright, and have only limited information to work with. The idea behind PBL is that when you are forced to look up information about a particular disease and then present it to your classmates, you’ll better learn the material and gain the important skill of working through a differential diagnosis.

At first, PBL sounds like a great idea. It gets you out of the classroom and allows you to think for yourself. If you take a quick look through SDN’s pre-med forums, you’ll see lots of college students creaming their pants at the hopes of joining a PBL school. My guess is that they’re sick of lecture halls and want a more intimate teaching environment.

PBL sounds like playing a grand master in chess who will lead you through the game, while he teaches you new moves on the board based upon your successes and failures. In reality, PBL is like playing a five-year-old where the child constantly changes the rules and then kicks you in the testicles to make sure that you won’t ever have a chance of winning. As the semester drags on, your group mates will get sick of making presentations and will eventually bail out of putting together any useful information in hopes that they can skate by with the just the bare minimum. Then, they’ll kick you in the nuts and go back to studying for the USMLE.

Case-based learning is not all bad. When there is an intended end and the preceptor is experienced in the subject, the material can indeed be learned quite readily. Lately, however, I feel as if I’m languishing through the module with the desire to put a bag of ice on my crotch, all the while saying, “I’m taking my toys home and never playing with you again.” Consider today’s case: the patient had tons of blood work, an endoscopy, a colonoscopy, a full-body CT scan, an abdominal ultrasound, and an MRI of the head. From all of these expensive tests we still don’t know the diagnosis. What he really needs is a biopsy and a physician to tell him to stop drinking so much. Or maybe someone to practice NOT my problem-based learning.